Effect of HIV-Infection on parasite clearance in pregnant women with severe malaria in Lacor and Gulu hospitals, Northern Uganda.

Abstract

TITTLE: Effect of HIV infection on parasite clearance in pregnant women with severe malaria in Lacor and Gulu hospitals, Northern Uganda. INTRODUCTION: Malaria and HIV/AIDS share determinants of vulnerability and have wide geographical overlap in occurrence. There is insufficient information on how HIV infection in pregnant women modifies therapeutic response in antimalarials. OBJECTIVES: We set out to compare the rate of malaria parasite clearance among HIV positive and HIV negative pregnant women with severe malaria on quinine. METHODS: A prospective cohort study conducted among pregnant women above 16 weeks with known HIV status admitted with severe malaria and a positive blood slide for malaria on quinine therapy. Parasite densities were done at admission and on days 1, 2, 3, 7 and 14. Data was analyzed using SPSS version 13.0. RESULTS: Sixty pregnant women with severe malaria, 27 HIV infected and 33 HIV negative, were treated with quinine and followed for 14 days. HIV infection was associated with significantly high parasite density at admission (p=0001). The rate of parasite clearance was significantly slower in HIV infected patients than the negative, they cleared only 38% of the parasite density at baseline by day 1 compared to 65% in the HIV negative (p=0.005). 85.2% the HIV positive patients still had parasitemia by day3 compared to only 24.2% in the HIV negative patients (p=0.0001). CONCLUSION: HIV infection in pregnant women with severe malaria in significantly associated with high parasite density and delayed clearance rates while on quinine therapy.